Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.23 / $11.23 / $16.00	Facility	26	$11.23	$11.23	$16.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.80 / $57.43 / $141.41	Professional		$47.80	$57.43	$141.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $13.01 / $30.37	Professional	26	$11.23	$13.01	$30.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.14 / $42.09 / $111.30	Professional	TC	$34.14	$42.09	$111.30
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $56.91 / $63.16 / $80.20	Professional		$56.91	$63.16	$80.20
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.63 / $16.26 / $20.65	Professional	26	$14.63	$16.26	$20.65
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $40.65 / $46.90 / $59.82	Professional	TC	$40.65	$46.90	$59.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.32 / $66.79 / $134.88	Professional		$44.32	$66.79	$134.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $16.18 / $30.46	Professional	26	$10.51	$16.18	$30.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.10 / $48.96 / $104.92	Professional	TC	$35.10	$48.96	$104.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.73 / $75.81 / $103.06	Professional		$62.73	$75.81	$103.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.38 / $15.65 / $21.64	Professional	26	$13.38	$15.65	$21.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $49.27 / $59.51 / $81.44	Professional	TC	$49.27	$59.51	$81.44
United Facility/Professional Professional Modifier Low / Median / High Price $42.22 / $55.47 / $99.77	Professional		$42.22	$55.47	$99.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.88 / $13.55 / $27.51	Professional	26	$10.88	$13.55	$27.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.93 / $42.59 / $75.73	Professional	TC	$31.93	$42.59	$75.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.81 / $68.97 / $89.61	Professional		$44.81	$68.97	$89.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.64 / $14.39 / $19.62	Professional	26	$9.64	$14.39	$19.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $35.17 / $54.74 / $69.98	Professional	TC	$35.17	$54.74	$69.98